| NPI | 1275193062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.019738) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14600) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-02-08 |